NPIMap

Organization Active NPI

Corbin Pediatric Associates PSC

  • Rural Health Clinic/Center
  • Corbin, KY
National Provider Identifier
1609960830
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
900173 Issued in KY
Legal business name
CORBIN PEDIATRIC ASSOCIATES PSC
Practice address
60 Bryan Boulevard
Ste 200
Corbin, KY 40701
Phone
(606) 528-9700
Fax
(606) 528-8423
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vernon Mitchell May, MDNPI 1184622987
Title
Managing Partner
Phone
(606) 528-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163W00000X
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X 900173 KY Primary
Pediatric Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

60 Bryan Boulevard
Ste 200
Corbin, KY 40701

Mailing address

60 Bryan Boulevard
Ste 200
Corbin, KY 40701
Phone (606) 528-9700

Other identifiers 1

IdentifierTypeStateIssuer
7100159920MedicaidKY

National Provider Directory

National Provider Directory

Locations

55 Waco Dr
London, KY 40741
Phone (606) 877-2757

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1609960830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BRYAN BOULEVARD",
            "address_2": "STE 200",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40701",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BRYAN BOULEVARD",
            "address_2": "STE 200",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "40701",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORBIN PEDIATRIC ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "606-528-9700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": "900173",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100159920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.